| Cheryl C. Fuller Phd Pa | |
|
1814 8th Ave # B Fort Worth TX 76110-1354 | |
| (817) 735-8222 | |
| (817) 924-1369 |
| Full Name | Cheryl C. Fuller Phd Pa |
|---|---|
| Speciality | Psychologist |
| Location | 1814 8th Ave # B, Fort Worth, Texas |
| Authorized Official Name and Position | Cheryl C. Fuller (PRESIDENT) |
| Authorized Official Contact | 8177358222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cheryl C. Fuller Phd Pa 4320 Bellaire Dr S Apt 226w Fort Worth TX 76109-5197 Ph: (817) 735-8222 | Cheryl C. Fuller Phd Pa 1814 8th Ave # B Fort Worth TX 76110-1354 Ph: (817) 735-8222 |
| NPI Number | 1689789901 |
|---|---|
| Provider Enumeration Date | 08/19/2006 |
| Last Update Date | 08/25/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689789901 | NPI | - | NPPES |
| 0012JC | Other | TX | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 2-3404 (Texas) | Primary |
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